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Is the MOC process driving some physicians into early retirement?

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Debate over the value of Maintenance of Certification goes on and on. On one side of the battlefield, some experts claim the process is just too onerous.



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A year has passed since the straightforwardly named organization Change Board Recertification was launched as a call to arms against Maintenance of Certification (MOC), but the debate among physicians over recertification shows no signs of being resolved any time soon. In fact, the summer 2011 issue of The Journal of American Physicians and Surgeons presents not one but two editorials that address the topic—challenging the utility, necessity, and cost of MOC. And a press release from the Association of American Physicians and Surgeons (AAPS) avers that the recertification process is so onerous that it may “drive our most seasoned, experienced physicians into early retirement”—or so AAPS Executive Director Jane M. Orient, MD, is quoted.

In one editorial, Martin Dubravec, MD, minces no words, calling board certification, recertification, and MOC “a malignant growth.”1 And in the other, Lee D. Hieb, MD, president of AAPS, writes that the process of recertification “benefits neither patients nor physicians, and certainly adds nothing to the time-honored practice of medicine.”2

In March 2010, the New England Journal of Medicine ran a clinical vignette and asked readers to vote on whether the internist described in the scenario should enroll in the current MOC program or not.3 Almost two thirds (63%) voted no. And an ongoing poll—admittedly unscientific—at the Change Board Recertification Web site reveals that 92.5% of respondents would abolish the process of recertification altogether.

In addition, a 2009 survey of 100 randomly selected members of AAPS found that only 30% felt that the process of recertification had improved their performance as a physician, and only 22% would voluntarily go through it again.

The American Board of Obstetrics and Gynecology has no figures on how many ObGyns choose not to pursue MOC. One reason for the lack of data: “It’s a 6-year process, and we’re only in year 4,” said MOC administrator Marsha Markham. She did confirm that more than 24,000 physicians are going through the MOC process.

“Right now, our numbers keep increasing each year,” she said.

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